Female pelvic organ prolapse is a common and treatable condition that limits a woman’s physiological function and sexuality, seriously affecting her health and quality of life. Depending on the severity of the condition, it can cause pressure-like discomfort, intermittent pain, and almost always affects the normal function of the bladder and rectum.
A. What are the symptoms of pelvic organ prolapse?
1, loss of bladder control, may also be accompanied by loss of bowel control
2, difficulty in urination Wu Yanhong, Department of Gynecology, Tianjin First Central Hospital
3, frequent urination
4, intestinal motility disorder
5.Bladder or vagina feels heavy, account, full and/or painful, or dropping
6.Recurring bladder infection
7.Excessive vaginal discharge
8. Discomfort or lack of sensation during sexual intercourse
What are the causes of the condition?
Although aging is the primary cause, there are many other underlying factors that contribute to this condition. These include loss of muscle tone, menopause and lowered estrogen levels, multiple vaginal deliveries, obesity, family history (connective tissue disease), history of pelvic trauma or previous surgery, repetitive weight bearing, chronic constipation, coughing, and other conditions.
How to treat pelvic floor organ prolapse?
1.Treatment of asymptomatic prolapse: active treatment is not advocated
(1)Regular observation
(2)Adjust reasonable diet
(3)Adjust bowel habits
(4) Avoid transient or chronic increase in intra-abdominal pressure
(5) Recommend appropriate weight reduction and reduction of smoking
(6) Pelvic floor rehabilitation training.
Kegel exercise (Kelel Exercise)-that is, the anal retractor muscle group to carry out voluntary contraction exercise, in order to increase the resistance of the urethra, vagina and anus, enhance urinary control, and can improve the vaginal “spit and suck” strength, but also conducive to pelvic floor blood circulation, muscle strength and elasticity, to prevent Atrophy and weakness.
Biofeedback method – pelvic floor electrical stimulation
2. Symptomatic prolapse.
(1)Uterine support treatment
(2) pelvic floor reconstruction surgery: the principle of surgery is to repair the defective tissue and restore the anatomical structure, while minimizing trauma, fully reflecting individualization, and appropriately and reasonably applying alternative materials.
Surgical route: mainly transvaginal, transabdominal and transabdominal laparoscopic or combined procedures.
Restorative anatomic surgery: surgery with the patient’s own supporting tissue structures.
Compensatory or alternative surgery: replacement with different types of grafts: pelvic floor reconstruction with the application of biological mesh (Prolift, Prosima) allows the reconstruction of the entire pelvis from the anterior, middle and posterior regions to fully correct pelvic floor defects. It is very good to correct patients with severe uterine prolapse, vaginal vault bulge, recurrence after anterior and posterior vaginal wall repair, and effectively reduce the recurrence
rate. Its objective cure rate is about 94.7% and subjective satisfaction rate is 97.6%.
Closed surgery: the vagina is surgically closed. It is suitable for patients who are old, frail and do not require sexual intercourse.